12 - Obs - Multiple Pregnancy - Antepartum MGMT Flashcards Preview

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Flashcards in 12 - Obs - Multiple Pregnancy - Antepartum MGMT Deck (5):
1

All multiples:

Early ???: Screening for ?abnormalities offered as normal. Chorionicity most accurately ascertained in ? trim – in ?? twins, dividing membrane is thicker as meets ? (? sign), in MC twins it is ? (T sign) and ? to the shared placenta. Nuchal translucency can also predict risk of ?? twin compx – greater when >?% discord.

USS
Chr
first
DC
placentas
Lambda
thin
perpendicular
MC
>20

2

All multiples:

General: Preg = ? risk, care ?
led. Iron and ? ? given. Multiple pregs incr maternal ? and ?. ? home help discussed.

ID of risk of preterm delivery: ????? of ? length may show those at most risk. Policy of inserting cervical ? in short cervix not advised but apprt if v ?, v ?.

high
consultant
folic acid
tiredness
anxiety
postnatal

TVUSS
cervical
sutures
short
early

3

All multiples:

Selective Reduction: To a twin preg at ?wks discussed w women w ? or higher. Slightly incr risk of ?, reduces chance of ? birth and ? ?. Reduction to twin singleton not advised. May also be done if one twin has ? abnormality. Safest before ? weeks.
ID of IUGR: More common and more ? to detect in multiple pregs vs singletons, serial ??? for ? usually routine done at ?, ? and 36wks.

12
triplets
miscarriage
preterm
cerebral palsy
congen
14

difficult
USS
growth
28
32

4

MC twins
USS surveillance starts at ?wks. TTTS most commonly diagnosed ?-?wks, by careful ??? inc ? regurg, or as ? around recipient causes abdo ?. Unless v ?, laser ? of placental ? using USS and ?
best -> lower neonatal ? rate than ?. MC twins also at higher risk of ???? and in utero ?, usually scanned every ?wks.

12
16-22
USS
tricuspid
polyhydramnios
distension
mild
photocoagulation
anastomoses
fetoscopy
handicap
amnioreduction
IUGR
death
2

5

Fetal Abnormality
Where one twin abnormal selective ??? discussed. In DC twins can be by ? injection of KCl 24wks), it can be offered after ?wks so if deliv ensues remaining twin will survive. In ?? twins the cord must be ? using bipolar diathermy, or its insertion ?, as circ is ?.

TOP
intracardiac
14
late
32
MC
occluded
ablated
shared

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